search
Back to results

A Phase I/II Open Label Study To Evaluate the Antiviral Potential of Combination Low-Dose Therapy With Zidovudine and Interferon-Alpha 2A in Patients With Symptomatic HIV Disease

Primary Purpose

HIV Infections

Status
Completed
Phase
Phase 1
Locations
United States
Study Type
Interventional
Intervention
Interferon alfa-2a
Zidovudine
Sponsored by
National Institute of Allergy and Infectious Diseases (NIAID)
About
Eligibility
Locations
Outcomes
Full info

About this trial

This is an interventional treatment trial for HIV Infections focused on measuring Interferon Alfa-2a, Drug Therapy, Combination, AIDS-Related Complex, Zidovudine

Eligibility Criteria

12 Years - undefined (Child, Adult, Older Adult)All SexesDoes not accept healthy volunteers

Inclusion Criteria Concurrent Medication: Allowed: Chemoprophylaxis for Pneumocystis carinii pneumonia (PCP), as aerosolized pentamidine. Ibuprofen. Acute therapy (7 days) with oral acyclovir. Acute therapy with ketoconazole. Patients must have: A diagnosis of AIDS related complex as well as defined symptoms within 12 months of study entry in the absence of concurrent illness or conditions other than HIV infection. Estimated life expectancy of at least 12 weeks. Positive serum p24 antigen > 70 pg/ml. Patients may have received prior zidovudine (AZT) and / or interferon alpha therapy, provided that: The total duration of treatment was < 6 months. Patients treated > 12 weeks but < 6 months should have received continuous therapy (no more than 14 consecutive days or 21 total days off during the treatment period). For patients treated = or < 12 weeks, continuous treatment means < 7 days off total during the treatment period. For all patients, a washout period of = or > 4 weeks must have elapsed prior to study entry. Treatment did not result in a major adverse reaction attributable to AZT or IFN-A2a such that rechallenge at a randomly assigned dosage level would be precluded. Exclusion Criteria Co-existing Condition: Patients with the following are excluded: Acquired immunodeficiency syndrome (AIDS) as defined by opportunistic infections. Significant cardiac (New York Heart Association Class 3 or 4), hepatic, renal, or neurologic disorder. Concurrent neoplasm other than basal cell carcinoma or in situ carcinoma of the cervix. Significant neurological disorder which impairs the patient's ability to give or receive informed consent or reduces the patient's performance status to the extent that protocol requirements and self-administration of drug cannot be accurately completed. Concurrent Medication: Excluded: All concomitant medications should be kept to a minimum. Chemoprophylaxis for Pneumocystis carinii pneumonia (PCP), other than aerosolized pentamidine. Other antiretroviral agents. Experimental medications. Biologic response modifiers. Systemic corticosteroids. Cimetidine. Ranitidine. Aspirin, acetaminophen, and nonsteroidal anti-inflammatory agents with the exception of ibuprofen. Barbiturates. Cardiac glycosides, antiarrhythmics, or vasodilators. Systemic treatment for an active infection, including pulmonary tuberculosis. Concurrent Treatment: Excluded: Systemic treatment for an active infection, including pulmonary tuberculosis. Patients with the following will be excluded from the study: AIDS as defined by opportunistic infections, Kaposi's sarcoma, or other AIDS defining neoplasms, HIV dementia complex, or HIV wasting disease. HIV constitutional disease. Any one of the following: Fever of > 38.5 degrees persisting for > 1 month. Involuntary weight loss of = or > 10 lbs or 10 percent of body weight. Diarrhea defined as = or > 2 liquid stools per day persisting for at least a total of 14 days without definable cause. Significant cardiac (New York Heart Association Class 3 or 4), hepatic, renal, or neurologic disorder. Concurrent neoplasm other than basal cell carcinoma or in situ carcinoma of the cervix. Significant neurological disorder which impairs the patient's ability to give or receive informed consent or reduces the patient's performance status to the extent that protocol requirements and self-administration of drug cannot be accurately completed. Prior AZT or IFN-A2a therapy for = or > 6 months. Previous major adverse reaction to AZT or IFN-A2a. Prior Medication: Excluded: Prior zidovudine (AZT) or interferon therapy for = or > 6 months. Excluded within 4 weeks of study entry: Any antiretroviral agent, Cytotoxic chemotherapy, or immunomodulator, including corticosteroids. Excluded within 30 days of study entry: Anti-infectives or agents likely to produce hematologic side effects (e.g., trimethoprim / sulfamethoxazole). Excluded: Cardiac glycosides, antiarrhythmics, or vasodilators. Active substance abuse.

Sites / Locations

  • USC CRS
  • Univ. of Miami AIDS CRS
  • Tulane Med. Ctr. - Charity Hosp. of New Orleans, ACTU
  • Massachusetts General Hospital ACTG CRS
  • University of Minnesota, ACTU
  • Beth Israel Med. Ctr. (Mt. Sinai)

Outcomes

Primary Outcome Measures

Secondary Outcome Measures

Full Information

First Posted
November 2, 1999
Last Updated
October 26, 2021
Sponsor
National Institute of Allergy and Infectious Diseases (NIAID)
search

1. Study Identification

Unique Protocol Identification Number
NCT00000696
Brief Title
A Phase I/II Open Label Study To Evaluate the Antiviral Potential of Combination Low-Dose Therapy With Zidovudine and Interferon-Alpha 2A in Patients With Symptomatic HIV Disease
Official Title
A Phase I/II Open Label Study To Evaluate the Antiviral Potential of Combination Low-Dose Therapy With Zidovudine and Interferon-Alpha 2A in Patients With Symptomatic HIV Disease
Study Type
Interventional

2. Study Status

Record Verification Date
October 2021
Overall Recruitment Status
Completed
Study Start Date
undefined (undefined)
Primary Completion Date
undefined (undefined)
Study Completion Date
November 1993 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
National Institute of Allergy and Infectious Diseases (NIAID)

4. Oversight

5. Study Description

Brief Summary
To evaluate the anti-HIV effect of single agent versus combination therapy with zidovudine (AZT) and interferon alfa-2a (IFN-A2a), as measured by p24 protein expression, viral growth and infectivity in patients with symptomatic HIV disease. To assess the safety of low dose schedules of AZT and IFN-A2a, alone and in combination, as measured by neutrophil counts and hepatic transaminase levels. To evaluate the comparative effects of single agent versus combination therapy with AZT and IFN-A2a on CD4 cell counts and skin test reactivity. AZT is known to be an effective treatment for HIV infection. However, patients may develop reactions to AZT when it is administered for long periods of time. Combining AZT with another drug at lower doses might reduce toxicity in patients and prevent the development of drug resistant strains. IFN-A2a can reduce the growth of HIV in test tube experiments and recent studies have shown that when AZT and IFN-A2a are used together they reduce the growth of HIV more effectively than when either drug is used alone. This study will examine the effectiveness and safety of these drugs when they are given together and compare these results with the effectiveness and safety of the drugs when they are used alone.
Detailed Description
AZT is known to be an effective treatment for HIV infection. However, patients may develop reactions to AZT when it is administered for long periods of time. Combining AZT with another drug at lower doses might reduce toxicity in patients and prevent the development of drug resistant strains. IFN-A2a can reduce the growth of HIV in test tube experiments and recent studies have shown that when AZT and IFN-A2a are used together they reduce the growth of HIV more effectively than when either drug is used alone. This study will examine the effectiveness and safety of these drugs when they are given together and compare these results with the effectiveness and safety of the drugs when they are used alone. AMENDED: 04-18-91 Treatment extended to 96 weeks. Patients are seen weekly for the first month and for the month following initiation of combination therapy (Cohorts 1, 2), then every other week until treatment week 48, followed by every week for the duration of the study. AMENDED: The doses have been modified to one of 4 total daily doses of AZT and one of 4 daily doses of IFN-A2a. AMENDED: Total treatment period will be 48 weeks. AMENDED: 9-24-90 Treatment will end 901214. Original Design: Before beginning any treatment, patients are carefully examined and evaluated. Each patient receives medication for 24 weeks, followed by a 4-week follow-up period. Patients are assigned randomly to one of four dosing schedules within one of three groups stratified according to whether or not they have ever received AZT and / or IFN-A2a: Group 1 receives AZT alone for 12 weeks, then AZT plus IFN-A2a for the following 12 weeks. Group 2 receives IFN-A2a alone for 12 weeks, then IFN-A2a plus AZT for the following 12 weeks. Group 3 receives the combination of AZT and IFN-A2a for 24 weeks. Medications are administered according to one of four possible daily dosing schedules of AZT plus IFN-A2a (increasing doses of each). AZT is taken by mouth as a capsule every 6 hours. IFN-A2a is given by an injection under the skin once a day. Initially, doses of IFN-A2a are given by one of the research staff, after which patients are taught to give their own injections. Patients are examined weekly for the first 4 weeks, then every other week until the end of the study. Patients assigned to groups receiving two drugs will be examined weekly again for 4 weeks when the second drug is added.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
HIV Infections
Keywords
Interferon Alfa-2a, Drug Therapy, Combination, AIDS-Related Complex, Zidovudine

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 1
Masking
None (Open Label)
Enrollment
48 (false)

8. Arms, Groups, and Interventions

Intervention Type
Drug
Intervention Name(s)
Interferon alfa-2a
Intervention Type
Drug
Intervention Name(s)
Zidovudine

10. Eligibility

Sex
All
Minimum Age & Unit of Time
12 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria Concurrent Medication: Allowed: Chemoprophylaxis for Pneumocystis carinii pneumonia (PCP), as aerosolized pentamidine. Ibuprofen. Acute therapy (7 days) with oral acyclovir. Acute therapy with ketoconazole. Patients must have: A diagnosis of AIDS related complex as well as defined symptoms within 12 months of study entry in the absence of concurrent illness or conditions other than HIV infection. Estimated life expectancy of at least 12 weeks. Positive serum p24 antigen > 70 pg/ml. Patients may have received prior zidovudine (AZT) and / or interferon alpha therapy, provided that: The total duration of treatment was < 6 months. Patients treated > 12 weeks but < 6 months should have received continuous therapy (no more than 14 consecutive days or 21 total days off during the treatment period). For patients treated = or < 12 weeks, continuous treatment means < 7 days off total during the treatment period. For all patients, a washout period of = or > 4 weeks must have elapsed prior to study entry. Treatment did not result in a major adverse reaction attributable to AZT or IFN-A2a such that rechallenge at a randomly assigned dosage level would be precluded. Exclusion Criteria Co-existing Condition: Patients with the following are excluded: Acquired immunodeficiency syndrome (AIDS) as defined by opportunistic infections. Significant cardiac (New York Heart Association Class 3 or 4), hepatic, renal, or neurologic disorder. Concurrent neoplasm other than basal cell carcinoma or in situ carcinoma of the cervix. Significant neurological disorder which impairs the patient's ability to give or receive informed consent or reduces the patient's performance status to the extent that protocol requirements and self-administration of drug cannot be accurately completed. Concurrent Medication: Excluded: All concomitant medications should be kept to a minimum. Chemoprophylaxis for Pneumocystis carinii pneumonia (PCP), other than aerosolized pentamidine. Other antiretroviral agents. Experimental medications. Biologic response modifiers. Systemic corticosteroids. Cimetidine. Ranitidine. Aspirin, acetaminophen, and nonsteroidal anti-inflammatory agents with the exception of ibuprofen. Barbiturates. Cardiac glycosides, antiarrhythmics, or vasodilators. Systemic treatment for an active infection, including pulmonary tuberculosis. Concurrent Treatment: Excluded: Systemic treatment for an active infection, including pulmonary tuberculosis. Patients with the following will be excluded from the study: AIDS as defined by opportunistic infections, Kaposi's sarcoma, or other AIDS defining neoplasms, HIV dementia complex, or HIV wasting disease. HIV constitutional disease. Any one of the following: Fever of > 38.5 degrees persisting for > 1 month. Involuntary weight loss of = or > 10 lbs or 10 percent of body weight. Diarrhea defined as = or > 2 liquid stools per day persisting for at least a total of 14 days without definable cause. Significant cardiac (New York Heart Association Class 3 or 4), hepatic, renal, or neurologic disorder. Concurrent neoplasm other than basal cell carcinoma or in situ carcinoma of the cervix. Significant neurological disorder which impairs the patient's ability to give or receive informed consent or reduces the patient's performance status to the extent that protocol requirements and self-administration of drug cannot be accurately completed. Prior AZT or IFN-A2a therapy for = or > 6 months. Previous major adverse reaction to AZT or IFN-A2a. Prior Medication: Excluded: Prior zidovudine (AZT) or interferon therapy for = or > 6 months. Excluded within 4 weeks of study entry: Any antiretroviral agent, Cytotoxic chemotherapy, or immunomodulator, including corticosteroids. Excluded within 30 days of study entry: Anti-infectives or agents likely to produce hematologic side effects (e.g., trimethoprim / sulfamethoxazole). Excluded: Cardiac glycosides, antiarrhythmics, or vasodilators. Active substance abuse.
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
D Mildvan
Official's Role
Study Chair
Facility Information:
Facility Name
USC CRS
City
Los Angeles
State/Province
California
ZIP/Postal Code
90033
Country
United States
Facility Name
Univ. of Miami AIDS CRS
City
Miami
State/Province
Florida
Country
United States
Facility Name
Tulane Med. Ctr. - Charity Hosp. of New Orleans, ACTU
City
New Orleans
State/Province
Louisiana
Country
United States
Facility Name
Massachusetts General Hospital ACTG CRS
City
Boston
State/Province
Massachusetts
Country
United States
Facility Name
University of Minnesota, ACTU
City
Minneapolis
State/Province
Minnesota
ZIP/Postal Code
55455
Country
United States
Facility Name
Beth Israel Med. Ctr. (Mt. Sinai)
City
New York
State/Province
New York
ZIP/Postal Code
10029
Country
United States

12. IPD Sharing Statement

Citations:
Citation
Zucker ML, Huberman KT, Hirschman SZ, Mildvan D. Stability of HIV-1 p24 antigen upon prolonged storage at -70 degrees C. The ACTG 068 Collaborative Team. Int Conf AIDS. 1992 Jul 19-24;8(3):44 (abstract no PuA 6203)
Results Reference
background
Citation
Mildvan D, Bassiakos Y. Zidovudine (ZDV) and interferon-alpha 2a (IFN): ongoing assessment of synergy and tolerance in early ARC patients, ACTG 068. The ACTG 068 Collaborative Group. Int Conf AIDS. 1992 Jul 19-24;8(2):B184 (abstract no PoB 3586)
Results Reference
background
PubMed Identifier
2231291
Citation
Mildvan D, Ruprecht R, Krown S, Pettinelli C. Methodological issues in AIDS clinical trials. Application of the combination index method in the design of a clinical antiretroviral trial: ACTG 068. J Acquir Immune Defic Syndr (1988). 1990;3 Suppl 2:S111-3 discussion S114-9. No abstract available.
Results Reference
background
PubMed Identifier
11321183
Citation
Mildvan D, Bassiakos Y, Zucker ML, Hyslop N Jr, Krown SE, Sacks HS, Zachary J, Paredes J, Fessel WJ, Rhame F, Kramer F, Fischl MA, Poiesz B, Wood K, Ruprecht RM, Kim J, Grossberg SE, Kasdan P, Berge P, Marshak A, Pettinelli C. Synergy, activity and tolerability of zidovudine and interferon-alpha in patients with symptomatic HIV-1 infection: AIDS Clincal Trial Group 068. Antivir Ther. 1996 Apr;1(2):77-88.
Results Reference
background

Learn more about this trial

A Phase I/II Open Label Study To Evaluate the Antiviral Potential of Combination Low-Dose Therapy With Zidovudine and Interferon-Alpha 2A in Patients With Symptomatic HIV Disease

We'll reach out to this number within 24 hrs